Medicalization of motherhood : managing maternal healthcare services in public hospitals in Islamabad, Pakistan

Abstract

The stipulation of protected and eminence care to patients is the most important concern of each hospital by considering their privileges and rights. Providing a range of free healthcare services to the population, in particular maternal healthcare as a priority is among the primary responsibilities of the state. In this regard, public hospitals play an important role in facilitating maternal medical care. In Pakistan, the management and utilization of available resources for mothers’ and newborns’ healthcare is always challenging due to limited resources and underprivileged constitution of governance. This study aims to investigate the performance of public hospitals which provide medicalized motherhood services all over the country within limited resources. By using qualitative research paradigm, interviews were conducted with the patients, doctors and staff to know their perceptions and experiences of the provision of maternal healthcare services at public hospitals in Islamabad, Pakistan. Participants were selected through purposive sampling approach. The researcher also engaged in participant observation to make the data more reliable by examining the genuine behaviour of the doctors and staff with the patients and vice versa. Bourdieu’s and Foucault’s respective theoretical framework on capital and power are adopted to analyze the condition of healthcare capital and medical dominance in public hospitals. The findings of the study supported Bourdieu’s theory of practice, verifying that the fabrication, financing and utilization of healthcare as capital and habitus of social system are in alliance with the health system. The findings show that public hospitals have separate unit for maternal healthcare and deliver paramount services to provide safe and quality healthcare services to mothers and newborns despite limited resources. Regarding patient’s safety, well- trained professional doctors and staff are functioning in the department but lack of resources to manage the larger population impedes the progress of the hospitals. Hospitals are deficient in physical and financial resources with respect to medicalized realm of maternal healthcare. Due to overburden of doctors’ work and lack of physical space, patients feel unsatisfactory towards the quality of services. The efficiency and appropriateness of the utilization of the resources have furthermore deteriorated because of the culture of power dominance existing in the hospitals. The study concludes that regardless of an immense and patterned public healthcare system, medicalization of motherhood in the public hospitals is not adequate and competent with respect to quality and efficiency of the services. It is recommended that professional growth of the healthcare providers as well as physical and financial resources need to be augmented in order to ensure the provision of quality healthcare services to mothers and newborns.